Abstract

Problem Illicit use of injected drugs is linked with high rates of HIV infection and fatal overdose, as well as community concerns about public drug use. Supervised injecting facilities have been proposed as a potential solution, but fears have been raised that they might encourage drug use.

Design A before and after study.

Participants and setting 871 injecting drug users recruited from the community in Vancouver, Canada.

Key measures for improvement Rates of relapse into injected drug use among former users and of stopping drug use among current users.

Strategies for change Local health authorities established the Vancouver supervised injecting facility to provide injecting drug users with sterile injecting equipment, intervention in the event of overdose, primary health care, and referral to external health and social services.

Effects of change Analysis of periods before and after the facility's opening showed no substantial increase in the rate of relapse into injected drug use (17% v 20%) and no substantial decrease in the rate of stopping injected drug use (17% v 15%).

Lessons learnt Recently reported benefits of supervised injecting facilities on drug users' high risk behaviours and on public order do not seem to have been offset by negative community impacts.

Footnotes

Contributors TK and EW designed the study. KL, RZ, and TK conducted the statistical analyses. TK and EW drafted the manuscript and incorporated all suggestions. JM, MT, and JS contributed to the conception and design of the analyses, interpretation of the data, and drafting of the manuscript, and all authors approved the version to be published. TK is guarantor of this study.

Funding The study was made possible through a financial contribution from Health Canada.

Competing interests None declared.

Ethical approval The study was approved by the University of British Columbia/Providence Health Care Research Ethics Board.